Sleep Apnea Syndromeを呈したDown症の3例

Three Cases of Down's Syndrome with Sleep Apnea Syndrome

　はじめに

　Guilleminaultらが提唱したsleep apnea syndomeをきたす先天性疾患には数多くのものが知られている^1,2,6）。今回，睡眠時の著明な呼吸障害や肺性心が，両側口蓋扁桃摘出や気管切開により著明に改善されたDown症の3例を経験したので報告するとともに若干の考察を行った。

Case 1: A 5-year-old boy presented with cor pulmonale and hypertrophy of the palatine tonsils (grade III).

Case 2:A 11-year-old girl presented with hyper-trophy of the palatine tonsils (grade III). In Cases 1 and 2, these symptoms and cor pulmonale were improved after tonsillectomy.

Case 3: A 35-year-old woman was admitted to hospital because of dyspnea with cyanosis due to cor pulmonale, and obesity. After tracheostomy sleep apnea, cyanosis, and cor pulmonale were improved. In case 1 and 2 obstruction of the hypopharynx by the palatine tonsils during sleep, in case 3 obesity were considered to play an im-portant role in an etiological factor. In addition, a general muscular hypotonicity and tendency of respiratory infection in Down's syndrome were also thought to be an etiological factor for sleep apnea syndrome.